Cancer treatment has changed significantly over the past few decades, and oncologists and oncology providers need to keep up with these changes. With new diagnostic and treatment options emerging at an accelerating rate, many oncologists find it invaluable to discuss these new approaches in a multi-disciplinary setting.
Tumor boards have become powerful tools in cancer treatment today. A tumor board is a meeting where a multi-disciplinary oncology team has the opportunity to discuss complex patient cases. Together, the care team reaches a consensus about the best care plan for the patient.
As with numerous aspects of patient care shifting to the online world, tumor board meetings are frequently digital and support remote attendance, making it easier to confer with multidisciplinary experts from a broad region. Some members of the care team request asynchronous participation to deal with busy schedules and multiple time zones. In many ways, tumor boards are changing the way cancer care is delivered, opening the door to new opportunities for patients.
We will take a closer look at the tumor board, how it can improve the care patients receive, and how oncologists can take advantage of a community of peers to enhance the level of care they deliver to their patients.
What is a tumor board?
A tumor board represents a multidisciplinary group of oncologists and other specialists who come together to discuss treatment options for individual cancer patients. Some of the types of physicians attending a tumor board are listed below:
The patient's primary treating oncologist will talk about the current treatment plan, the results of previous treatments, and various cancer treatment options.
A pathologist will describe the tumor grading decision and what they considered before making the final diagnosis. The pathologist may recommend additional diagnostic procedures if open questions remain about a patient's tumor.
A surgeon may present surgical options and address any surgical questions around a particular patient.
A medical oncologist may propose systemic therapies to treat late-stage disease or to deal with the potential of distant metastasis.
A radiation oncologist may propose localized or adjuvant radiation therapy.
Other hospital providers or physicians may offer opinions or suggestions about clinical trials and treatment options that can impact the patient outcome.
A tumor board is frequently a hybrid between a physical conference and a virtual meeting. Teams can conduct virtual tumor boards with video conferencing software or asynchronous messaging software so that various contributors can leave their feedback regarding the final treatment decision for the patient.
What cases go to a tumor board?
Evidence-based recommendations, such as the NCCN guidelines, were created to guide physicians toward optimal treatment approaches. The established guidelines readily address most common cancers. Consequently, oncologists typically reserve tumor boards for more challenging or unusual cases. Some topics that may be presented at a tumor board are listed below:
Patients who have exhausted all of their standard treatment options and might benefit from experimental or alternative treatment options.
Cases where the oncologist or the pathologist has difficulty making a final diagnosis. The oncologist might review the initial symptoms, and the pathologist will review the biopsy. They might solicit opinions from other specialists in attendance for other ideas regarding a final diagnosis.
Oncologists may discuss rare or unusual cancer diagnoses for which there might not be an established standard of care. The tumor board may debate various treatment options and arrive at a consensus about how to treat the patient.
It is common practice at teaching hospitals for residents or fellow physicians to present clinical cases for practice.
How often do tumor boards meet?
The frequency with which tumor boards meet can vary significantly, from weekly to monthly. Occasionally, the tumor board needs the participation of other specialties, so a special highly attended tumor board might meet quarterly to discuss particularly challenging or rare cases. The exact schedule is up to the hospital and the physicians involved.
A tumor board will review several topics for a typical cancer case. They include the current standard of care, the possibility of radiation, different chemotherapy agents, and the possibility of surgery either before or after other treatment options. The tumor board meeting will also assess the suitability of clinical trials, palliative care options, and supplements that could improve the patient’s overall quality of life. The goal of a tumor board meeting is to develop the optimum treatment plan for the patient.
The power of a physician community
A tumor board is a powerful tool because it gives oncologists the ability to confer with and learn from other doctors, many of whom may work in different specialties. An effective tumor board can improve the level of patient care.
Oncologists can take advantage of opportunities to connect with physicians and receive guidance on their complex cases. We recognize that sometimes even the experts need experts, and oncologists rely on one another to ensure they consider the best options for their patients. Another way to connect with peers outside of tumor boards is to join the Primum community.
Oncologists can use Primum to hold 1:1 conversations with other oncologists about complex cases. Alternatively, one can consult 1:1 with several specialists, which is similar to a small asynchronous tumor board. Leveraging Primum, an oncologist can collaborate with a broad network of physicians to solicit numerous perspectives, which might help provide better care to their patients.
“Cancer Tumor Boards – How Can They Help Patients?” Cancer Commons, https://www.facebook.com/CancerCommons, https://cancercommons.org/latest-insights/cancer-tumor-boards-how-they-help-patients/. Accessed 6 June 2022.
“The Impact of Tumor Board on Cancer Care: Evidence from an Umbrella Review | BMC Health Services Research | Full Text.” BioMed Central, https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-4930-3. Accessed 6 June 2022.
“The Impact of Tumor Board on Cancer Care: Evidence from an Umbrella Review - PubMed.” PubMed, https://pubmed.ncbi.nlm.nih.gov/32005232/. Accessed 6 June 2022.
“The Important Role Tumor Boards Play in Cancer Care | Fox Chase Cancer Center - Philadelphia, PA.” Fox Chase Cancer Center - Philadelphia, PA |, 26 July 2018, https://www.foxchase.org/blog/important-role-tumor-boards-play-cancer-care.
“Tumor Boards - Cancer Center | Stanford Health Care.” Stanford Health Care (SHC) - Stanford Medical Center | Stanford Health Care, https://stanfordhealthcare.org/medical-clinics/cancer-center/cancer-tumor-boards.html. Accessed 6 June 2022.
“Tumor Boards - Lahey Health Cancer Institute.” Lahey Health Cancer Institute, https://www.lahey.org/cancer-institute/our-personalized-approach/tumor-boards/. Accessed 6 June 2022.
“Tumor Boards and the Quality of Cancer Care - PMC.” PubMed Central (PMC), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4481638/. Accessed 6 June 2022.
“Tumor Boards: Optimizing the Structure and Improving Efficiency of Multidisciplinary Management of Patients with Cancer Worldwide - PubMed.” PubMed, https://pubmed.ncbi.nlm.nih.gov/24857140/. Accessed 6 June 2022.
“What Is a Tumor Board? An Expert Q&A | Cancer.Net.” Cancer.Net, 12 July 2017, https://www.cancer.net/blog/2017-07/what-tumor-board-expert-qa.
Doug is Primum's Head of Network Development & Partnerships. Prior to Primum, he was an early employee with Gerson Lehrman Group (GLG) spending 15+ years establishing expertise matching networks in healthcare and analytics.